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Age distribution of liver cancer. The horizontal axis represents year and the vertical axis represents the number of liver cancer patients in different age groups.
Source publication
Analysis of the related risks of disease provides a scientific basis for disease prevention and treatment, hospital management, and policy formulation by the changes in disease spectrum of patients in hospital. Retrospective analysis was made to the first diagnosis, age, gender, daily average cost of hospitalized patients, and other factors in the...
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There is a growing interest in the factors that influence short-term mortality and readmission after hospitalization for acute myocardial infarction (AMI) since such outcomes are commonly considered as hospital performance measures. Socioeconomic status (SES) is one of the factors contributing to healthcare outcomes after hospitalization...
Background:
We estimated the cost-per-episode and the annual economic burden associated with influenza in Kenya.
Methods:
From July 2013-August 2014, we recruited patients with severe acute respiratory illness (SARI) or influenza-like illness (ILI) associated with laboratory-confirmed influenza from 5 health facilities. A structured questionnair...
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Background
Early surgical intervention in the treatment of proximal femur fractures has been shown to significantly reduce mortality and complications. Our study intends to evaluate early surgery rates in a single-center analysis before the clinical advantages of early surgical intervention were demonstrated in the literature (G1), after the orthop...
Objective:
Primary hyperparathyroidism (PHPT) is one of the most frequently diagnosed endocrine disorders, but few studies have focused on hospital management of the disease in Europe. We investigated the frequency of hospital admission for diagnosis and surgical treatment of PHPT in Italy.
Design:
A retrospective study was conducted for investi...
Citations
... 5 Analyzing the spectrum of diseases facing neonates and other age groups can provide an evidence-based foundation for efforts to prevent disease, treat patients, manage hospitals, and formulate appropriate policies. 6 The advent of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which rapidly spread throughout the world after first emerging in December 2019, 7,8 has had a profound and sweeping impact on healthcare systems and society as a whole. Efforts to slow the spread of disease led to the introduction of hygiene-focused countermeasures, including social distancing, hand washing, mask-wearing, and reductions in contact numbers. ...
Background and Aims
Neonatal diseases are a significant threat to global public health, affecting the homeostasis and well‐being of patients and reflecting the status of, and challenges to, regional, national, and global healthcare systems. This study sought to investigate how the disease spectrum observed among neonatal inpatients changed after the onset of the coronavirus disease 2019 (COVID‐19) pandemic.
Methods
The present hospital‐based retrospective study analyzed the demographic and clinical characteristics of 19,943 hospitalized newborns from January 2018 to December 2022 using data derived from pediatric department registers.
Results
According to the International Classification of Diseases 11th Revision (ICD‐11) classification criteria, the two most common neonatal disorders during this study period were “Certain conditions originating in the perinatal period” and “Disease of the respiratory system.” Following the start of the COVID‐19 pandemic (2020 onwards), the number of neonatal patients declined markedly (5742 per year vs. 2820 per year), and the incidence of “Disease of the respiratory system” was significantly lower than in 2018–2019 (25.72% vs. 17.46%).
Conclusion
The study offers detailed insights into the shifts in neonatal disease patterns at the Seventh Medical Center of the PLA General Hospital following the onset of the COVID‐19 pandemic, providing a foundation for future research and policymaking efforts.
... According to recent studies conducted in tier 2 or tier 3 hospitals, the most common top diseases among inpatients were neoplasms, circulatory diseases, respiratory diseases, factors affecting health status and nervous system diseases. [35][36][37][38][39] In our study, we found some differences in the most common diseases for primary healthcare visits and specialist visits. The specific diseases varied more substantially, with CHSCs more often dealing with primary and common diseases. ...
Objectives
This study aims to analyse the disease composition of primary care visits rather than specialist visits, the former of which had scarcely been studied. We adopted specific disease classification (International Statistical Classification of Diseases and Related Health Problems, 10th Revision), disease system and communicable/non-communicable/injury disease classification, and variations of sex and age were also analysed.
Setting
We extracted data from all community health service centres (CHSCs) and community health service stations in Pudong, Shanghai, from 2016 to 2018 using the electronic health record systems of the Pudong health information centre.
Participants
Our data included all 46 720 972 primary care visits from 2016 to 2018 in CHSCs in Pudong.
Results
We found that the top five diseases in primary care visits continued to be primary hypertension, problems related to medical facilities, chronic ischaemic heart disease, unspecified diabetes mellitus and acute upper respiratory infection. Lipoprotein metabolism disorder visits continued to increase over the study years. The numbers and proportions of patients with hypertension and unspecified diabetes were higher among men than women, and other cerebrovascular diseases were higher among women than men. The top five disease systems were circulatory system diseases, respiratory system diseases, endocrine/nutritional/metabolic diseases, factors influencing health status and digestive system diseases. The rankings of respiratory system and endocrine/nutritional/metabolic diseases rose over time. Non-communicable diseases (NCDs) accounted for approximately 90% of the primary care visits—a much higher percentage than other causes. The top five NCDs in primary care visits were cardiovascular and circulatory diseases, musculoskeletal disorders, diabetes, digestive diseases and urogenital diseases. Compared with women, men suffered from cardiovascular diseases at an earlier age.
Conclusions
Different from specialist visits, common diseases, especially NCDs, were the main disease composition of current primary healthcare visits while the former focused on intractable diseases such as tumours, indicating that primary healthcare had played the role of gatekeeper of the healthcare system.
... However, these data are sampled and are usually targeted at the cause of death and the morbidity rates of specific diseases, including some infectious diseases and a small proportion of chronic diseases, such as cancer. Second, although existing research has studied disease patterns, few have explored the characteristics of those patients who primarily seek service in community institutions [5][6][7][8]. To increase the accuracy of the morbidity rates of broader categories of infectious diseases and NCDs, increasing numbers of studies are beginning to focus on the high-level data, such as inpatient and outpatient electronic health records (EHRs), which are collected from healthcare institutions. ...
Background:
Since 2000, China has been developing primary care institutions to serve as the gateway to the healthcare system. However, the investment of resources in primary care institutions is not based on the actual medical demands of the public. This study analysed primary care utilization to provide targeted guidance for the improvement of primary healthcare delivery in China.
Methods:
We extracted outpatient visit data from all community healthcare centres in Shanghai from 2014 to 2018. Diseases were then classified according to ICD-10 codes. The disease spectrum (frequency, proportion, rank) was stratified by sex, age, and region.
Results:
Most primary care outpatients were female (58.20%), 60-79 years old (57.91%), and in suburban regions (62.18%). Chronic diseases accounted for the majority (91.41%). Hypertension, chronic ischaemic heart disease, diabetes, and acute upper respiratory tract infections were the top four disorders for primary care visits regardless of sex. In the group aged 0-18 years, symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified accounted for 37.96% of the top 20 reasons. Acute upper respiratory tract infections were the most common diseases in the groups aged 0-18 (11.20%) and 19-39 (11.14%) years. However, hypertension was the most common disease in the group aged > 39 years old (> 20%). There were more outpatients with respiratory and digestive diseases in suburban areas than in urban areas. In addition, problems associated with medical equipment and other healthcare deficiencies were relatively more common in suburban areas (suburban: 4.13%, rank 5; urban: 2.29%, rank 10).
Conclusions:
To meet the patients' needs and to develop the primary care system, the Shanghai government should focus on diseases with regionally high proportions. Disease diagnosis and treatment should be improved in the younger and suburban populations.
... Diabetes has become one of the most common chronic diseases among older Chinese people (i.e. 60 years or older), with the prevalence being 20.4% [1] and more than 22.5% [2] in two major studies. It is estimated that more than 50% of patients with diabetes in China are above 60 years [3]. Given the robust increase in life expectancy and dramatic increase in the prevalence of unhealthy diet and lifestyle due to rapid economy growth and social development, the number of older peoples with diabetes will continue to increase in China. ...
Background
Although older diabetes patients with unique characteristics should be cared carefully to improve their health-related quality of life (HRQOL), the association between diabetes and HRQOL remain unclear, especially in Asians. We aimed to compare the HRQOL between older Chinese patients with type 2 diabetes (T2D) and their age-gender-matched controls.
Methods
Older patients with T2D were recruited from a community hospital in Suzhou located in the east part of China while controls were selected from a community-based health survey of older adults aged 60 years or older. HRQOL of cases and controls was assessed by the EQ-5D-3L. The impact of T2D on HRQOL was investigated using a liner regression model and the relationship between T2D and EQ-5D health problems was evaluated using logistic regression models.
Results
A total of 220 cases and 440 controls were included. The mean age of the participants was 68.8 years and women accounted for 69.1% of the study sample. The EQ-5D-3L index score was lower for older people with T2D (0.886) than their controls (0.955). After multivariable adjustment, the difference in ED-5D-3L index score between older people with and without T2D was 0.072. In logistic regression analyses, T2D was positively associated with reporting of problems in mobility (odds ratio [OR] = 5.00); pain/discomfort (OR = 1.66), and anxiety/depression (OR = 3.2).
Conclusions
T2D has a detrimental effect on HRQOL of older Chinese people.
... 12 As advances in science and technology, in the 21 st century, diseases threatened human beings in the past have been under control and chronic diseases, psychological diseases and sub-health statuses have become the dominant health problems. 13 Whole person care including the body, mind and spirit is required in primary care practice. 14,15,16 Bio-psycho-social model insists on that, not only biological, psychological, social and ecological factors can also cause diseases affecting health. ...
BACKGROUND: The features of primary care are well described on the dimension of public health. Primary care clinicians consist of a large portion of health-care workforce. To guide clinical thinking in primary care practice, its basic clinical principles should be synthesized.
METHODS: We searched literature in PubMed, MEDLINE, China National Knowledge Infrastructure, and Wanfang Med Online, using the key words of “primary care practice”, “primary care”, “primary health care”, “general practice” in combination with “principle”, “ideal”, “description”, “characteristic” and “feature” to synthesize basic clinical principles of primary care practice.
RESULTS: Six basic clinical principles of primary care practice are synthesized. 1. Holistic: includes holism, whole person care, bio-psycho-social model, lateral clinical thinking, and overcoming fragmented specialization. 2. Integrative: consists of combination of orthodox and complementary medicine, coordinated care, and practicing holistic integrated medicine(HIM). 3. Continuous: deals with continuous clinician-patient relationship, seamless services, life-cycle medical services, and full medical care at any time and place. 4. Preventive: contains undifferentiated disease care, health habit counseling, screening for asymptomatic diseases, and immunization. 5. Patient-centered: comprises responsive to individual patient needs and values, people-oriented care, and practicing Patient Centered Medical Home (PCMH). 6. Standardized: involves use of evidence-based medicine (EBM), following the clinical guideline, and applying clinical pathway.
CONCLUSION: The six basic clinical principles of primary care practice are holistic, integrative, continuous, preventive, patient-centered and standardized care. They might be the backbone of primary care practice and be recommended to be used to construct the disciplinary knowledge of clinical primary care practice.
KEY WORDS: Primary care practice, primary care, primary health care, general practice.
... The disease spectrum of Chinese people and general attitudes toward health have transformed. [5][6][7] The demand for better health services of Chinese nationals is still increasing with greatly improved living standards. 4,8 Consequently, such alterations have increased the prevalence of the ecdemic medical care/treatment. ...
Purpose
This study aimed to determine the factors that influence patient satisfaction with ecdemic medical care.
Materials and methods
Eight hundred and forty-four face-to-face interviews were conducted between October and November 2017 in two high-profile hospitals in Nanchang, China. Patient satisfaction was divided into lowest and highest satisfaction groups according the 80/20 rule. Demographic factors associated with patient satisfaction were identified by logistic regression models.
Results
Respondents’ main reasons for choosing a non-local hospital were “high level of medical treatment” (581/844), “good reputation of the hospital” (533/844), and “advanced medical equipment” (417/844). The top three items that dissatisfied the ecdemic patients were “long time to wait for treatment” (553/844), “complicated formalities” (307/844), and “poor overall service attitude” (288/844). Fewer female patients (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.03–2.11), patients with a family per-capita monthly income (FPMI) between 3,001 and 5,000 CNY (AOR =1.40, 95% CI =1.01–2.17), inpatients (AOR =1.46, 95% CI =1.01–2.13), and more patients with an FPMI >7,000 CNY (AOR =0.43, 95% CI =0.20–0.92) were detected in the lowest satisfaction group. Fewer patients with an associate’s or bachelor’s degree (AOR =2.40, 95% CI =1.37–4.20) and patients with an FPMI >7,000 CNY (AOR =3.02, 95% CI =1.10–8.33) were detected in the highest satisfaction group. Moreover, more inpatients (AOR =0.70, 95% CI =0.54–0.97) and those aged 46–65 years (AOR =0.63, 95% CI =0.33–0.98) were detected in the highest satisfaction group.
Conclusion
Findings suggested that managers of the medical facilities should note the importance of increasing their publicity through a rapidly developing media, as well as the necessity of creating a more patient-friendly medical care experience. Hospitals should also focus on the medical care experience of patients with relatively lower and higher income levels, male ecdemic patients, and ecdemic outpatients.
... With the growth of the already large elderly population in China, these four respiratory diseases promise to become a huge burden on society. From another perspective, the health policy "national basic medical insurance" has benefited many more people in China [31], which is also a potential reason for the increment. ...
Chronic obstructive pulmonary disease (COPD), pneumonia, asthma, and lung cancer are four common respiratory diseases that impose a substantial economic burden on both patients and government in China. The objective of our study is to analyze the temporal trends of several clinical tracking metrics for hospitalization regarding these diseases. Hospital discharge data of 54 hospitals for the period 2005–2015 were derived from the Health and Family Planning Commission in Northeast China. The age-adjusted rate of discharge for the four respiratory diseases increased significantly (COPD, pneumonia, asthma: P trend < .001; lung cancer: P trend = .046). The mean LOS for the four diseases all showed a significant decline ( P trend < .001), whereas the mean charge per stay and aggregate charge followed an upward trend over time ( P trend < .001). There was a clear upward trend for the readmission rate for asthma patients ( P trend = .001), while the trend for COPD patients was unclear ( P trend = .224). Age-adjusted discharge rates, LOS, and charges for hospitalization regarding several common respiratory diseases in China showed different patterns of change over the past decade. Our results should aid government and administrators in making informed decisions about the management and treatment of respiratory diseases.
... In 2012, a Lancet editorial, taking China as a typical example, urged countries in transition to "scale up the quality and quantity of services" brought by evidencebased nursing since "there are fewer nurses than medically trained staff" (Lancet, 2012). Actually, with the transition of economy, environment, and disease spectrum (Zhang et al., 2014;Yang et al., 2013), China's severe nursing shortages have already lead to problems (e.g., low level of job satisfaction, poor retention and burnouts; Lu, While, & Barriball, 2007;Tao, Zhang, Hu, & Zhang, 2012), increasing the difficulty of meeting high demand for better health care (Yau et al., 2012). To some extent, the urgent demand for improving health and safety of patients in a cost-effective manner has paved the way for evidence-based nursing in the Chinese health care system. ...
Background:
It is crucial to identify the challenges of evidence-based nursing implementation faced by countries in transitional stage.
Purpose:
The purpose of this study was to identify the state of evidence on implementation in Chinese nursing contexts and to determine gaps that need to be pursued.
Methods:
We performed a scoping review on existing literature on implementation studies conducted in nursing context in Mainland China. After systematically searching eight (four Chinese and four English) databases, we extracted and analyzed data from the included studies.
Results:
Ninety-five articles met inclusion criteria. Publications were on the rise, with most funding from academic institutions. Most studies were quantitative, with patient outcomes as primary indicators. Eighteen studies used a theoretical framework. Frequently used strategies and barriers to evidence-based nursing implementation were mainly from the organizational level.
Conclusions:
This scoping review indicates an urgent requirement of Chinese evidence-based nursing resources, more funding and support from clinical managerial level, cooperation between academic and clinical institutes, and a call for more rigorous studies of implementation science under a Chinese nursing context.
... Diabetes mellitus care accounts for 6% and 10% of total healthcare expenditure in China and Singapore respectively [6,7]. In both countries, approximately 1.7% to 2% of hospitalisations are due to diabetes mellitus [2,8]. Despite the same glycaemic targets, diabetes mellitus management in Singapore and China remains largely different. ...
Aim: There is a worldwide increasing prevalence of diabetes mellitus. Although everyone has the same aim to achieve good glycaemic control, diabetes mellitus care is largely variable across the world. Diabetes mellitus care imposes a significant economic burden on the national healthcare system. Inpatient care accounts for the bulk of healthcare cost for patients with diabetes mellitus and these patients have an increased risk of recurrent hospitalizations. There is a need to seek continual improvement in our care for diabetes mellitus and there is much to learn from best practices in various countries. Medical exchange programs are useful for identifying similarities and differences between institutions and allow adaptation of good medical practices. Methods: This is a descriptive, cross-sectional study comparing diabetes mellitus care in two tertiary hospitals, one in Shanghai, China and the other in Singapore. Comparisons are based on independent observations and interviews with medical doctors during a medical exchange program in September 2016. Results: There was stark difference in the inpatient diabetes mellitus care. In Shanghai, subcutaneous continuous insulin infusion therapy, continuous glucose monitoring (CGM) and eight-point capillary glucose level checks were routinely used for inpatient glycaemic control. However, in Singapore, subcutaneous continuous insulin infusion therapy and CGM are used mainly in the outpatient setting. Conclusion: Compared to basal-bolus insulin regimens, subcutaneous continuous insulin infusion therapy would best mimic endogenous insulin secretion. However, its use for inpatient glycaemic control still lacks conclusive evidence about benefits and safety, and should be evaluated on a larger scale.
What is already known about this topic?:
Noncommunicable diseases (NCDs) are a major public health problem in the world. NCDs are the leading cause of premature deaths and disabilities among Chinese residents, resulting in heavy economic and health burdens.
What is added by this report?:
This study conducted a quantitative analysis of the policy texts on NCDs prevention and control in China from 1990 to 2020, based on the perspective of policy instruments. It was discovered that China's NCDs prevention and control policies developed rapidly from the ground up over the 30 years from 1990 to 2020 and that the majority of China's NCDs prevention and control policies were environment-oriented, while supply-oriented and demand-oriented policies were insufficient.
What are the implications for public health practice?:
The findings of this study suggested that increasing supply-oriented and demand-oriented strategies should be prioritized in the future formulation and revision of NCDs prevention and control policies.
